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Acute HIV Concerns
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Acute HIV Concerns

Hi Doctor,

I'm 30, male, straight, non-drug user. Sick for 6 weeks.

First 3 weeks: symptoms began all at once with fever, lymph swelling (first in groin, later in neck), moderate night sweats (for 3 weeks) & painful red-dotted tip of tongue (diagnosed geographic tongue). Possible oral thrush, nystatin had little effect. 2 large canker sores appeared on lip & resolved in a week. No rash & felt overall energetic (not fatigued) but did experience exercise intolerance (unusual nausea, faintness after walking in park).

Second 3 weeks: night sweats largely disappeared but red-dotted tip of tongue continues, fatigue began. Burning lungs (diagnosed mild bronchitis), malaise, unusually severe bruising on arm following blood work, and, most alarming, small (1mm diameter) recurring purpura on buccal mucosa. Purpura arise suddenly, and are black or red. They fade over the course of < 5 days.

5th week CBC results, compared with those of 3rd week, show falling platelets (235 in week 3 vs. 172 in week 5),  falling neutrophil (3.3 vs. 2.3) falling WBC (4.9 vs. 4.1), falling RBC (4.92 vs. 4.63). Lymphocyte rose from 3rd week @ 1.2 to 5th week @ 1.4

Risks: < 6 incidents of unprotected vaginal sex with 4 different women of unknown status since 01/01/2012. The most recent exposure was 5 days before symptoms began.

Tested with Abbott Architect HIV Ag/Ab Combo @ 7, 15, 22 & 28 days post last exposure. Tested with Rapid Point of Care HIV Antibody test 38 days post last exposure (33 days after symptoms first began). Combo and Rapid results were all Negative.

Liver & kidney function normal. Hep A,B,C tests Negative. Monospot Negative.

Suffering severe anxiety, primarily in light of buccal mucosa purpura, burning lungs & worsening fatigue. Will retest @ three months. Please advise re: reliability of HIV test results,  any other insights into what might be causing these symptoms & any blood work or tests you'd run on me. Doctors doubt HIV but seem otherwise mystified.

Thanks
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239123_tn?1267651214
Welcome to the forum and thanks for your question.  I can help. I reviewed your discussion about all this on the HIV community forum and agree with the reassuring responses you had there (but which you seem to have trouble accepting and believing).

You can be certain you do not have HIV and that something else explains your symptoms.  Of all the information provided in your question, by far the most important is your negative HIV test results.  Given the specific tests you had and their timing, they prove you don't have HIV.  When testing is done sufficiently long after exposure, the results always overrule exposure history, symptoms, and other lab test results.

Given that fact, I'm not going to spend any time anlayzing your symptoms, except to say they are not as typical of ARS as you seem to think.  In addition, the sexual lifestyle you describe is not especially high risk for HIV, and it statistically unlikely you were exposed to it.  But I'll say the important information once again, in the hope it will sink in:  even if you had the highest risk exposure imaginable, and even if your symptoms and various lab tests were highly suggestive of ARS, the HIV diagnostic test results tell the truth.  And by the way, CBC results naturally vary within the range of your results; the differing WBC levels at various times are meaningless.

In case you are interested in more discussion about HIV test results and their reliability at various times after exposure, see the following recent thread, as well as the other threads whose links are provided in it:  http://www.medhelp.org/posts/show/1704700.

In other words, I am in exact agreement with your "Doctors [who] doubt HIV", and I am confident your problems have nothing at all to do with your sexual partners or your sexual lifestyle.  Continue to work with your doctors about what's going on, but try to stop worrying about HIV.  You don't have it.

Good luck--   HHH, MD
4 Comments
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Avatar_m_tn
Thank you, Doctor.

I'm relieved to know that HIV is definitely not the cause. Thank you also for your comments on my CBC results. I have two follow up questions.

1. Is there any likelihood that Herpes or Mono might have triggered my illness? I had a marked relief of symptoms during week 2 while taking Valtrex + Nystatin. (One doctor initially diagnosed my tongue as HSV1.) Speaking of my tongue, here’s a photo of the still unresolved inflammation: http://www.medhelp.org/photos/show/7769562?type=posts (Often the red migratory circles have a white border.) Please let me know if the admittedly imperfect photo suggests anything to you, sexually transmitted, or otherwise.

2. Finally please indulge me with a word or two about one other suspicion of mine. 6-8 hours before my first symptoms of fever & lymph swelling began, I spent 2 hours with no breathing mask in humid, very warm & unventilated conditions removing radically foul-smelling, mouldy, water-soaked carpet from my long flooded basement. Do you think it remotely possible that a bacterial or fungal exposure from 2 hours of heavy breathing in such an environment could trigger this prolonged, odd illness? I still live in the same house, seasonally battle with jock itch, and my basement is routinely damp/watery due to spring melt. I don’t need a long answer, just a “not a chance,” “maybe” or “moderately probable” would suffice.

Thanks again for your help.
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Avatar_m_tn
Hi Doctor,

I apologize for my last post. I'm going to stay on the topic of HIV. I believe that its almost impossible that I have HIV, given my tests, but I know I'm getting sicker and I'm still presenting with symptoms. I had risky sex. I may have contracted Herpes--but what I'm suffering from is not Herpes per se, but maybe an auto-immune reaction to it. Perhaps its Amyloidosis. I've uploaded some photos to my account:

http://www.medhelp.org/user_photos/show/265673

http://www.medhelp.org/user_photos/show/265671

Please tell me if these oral symptoms look similar to those caused by Acute HIV or Herpes. I'm having shortness of breath, pronounced grooves in the sides my tongue, especially in the morning, and new blood filled purpura in my mouth daily. Please anything you can tell me would provide me some relief.

I'm still racked with worry. I have no one to turn to. My parents are away on vacation. And I'm afraid to spend time with friends because its cold season and I don't think I could fight off another illness on top of this one.

Please Doctor, help me regather my wits.

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239123_tn?1267651214
On this forum we do not examine clinical photos, and MedHelp doesn't permit the personal profile page to be used for that purpose.  Remove them immediately or the web administrator will do so.

It is a mistake to try to find a diagnosis online, either on this forum or elsewhere on line.  We give only general opinions -- and on this forum that doesn't include things other than HIV or STDs.  You should see a doctor or clinic in person.  I also suggest you cease any further online searching.  You have only come up with outlandish explanations that make no sense.

As already discussed, your health problem probably has nothing to do with your sexual exposures.  Your parents being away is irrelevant; you're a 30 year old adult and entirely responsible for your own health care.  Neither your doctor nor anyone else is going to tell you parents anything you don't want them to know, unless you do it yourself.

This thread is over; no more comments or questions, please.  (And do not start a new thread with the same questions.  It would be deleted without reply, and without refund of the posting fee.)
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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